NEW YORK PRACTICAL NURSE COMPREHENSIVE REVIEW PRACTICE EXAM |
STUDY GUIDE | TESTBANK | LATEST UPDATE 2026/2027 | 30 ADVANCED
QUESTIONS | 100% CORRECT ANSWERS
Table of Contents
i. New York Practical Nursing Scope of Practice and Professional Regulation
ii. Clinical Judgment, Prioritization, Delegation, and Patient Safety
iii. Pharmacology and Medication Administration
iv. Adult Medical-Surgical Nursing and Complex Disorders
v. Cardiovascular, Respiratory, Neurologic, and Endocrine Emergencies
vi. Maternal-Newborn and Pediatric Nursing
vii. Mental Health, Ethics, Communication, and Legal Responsibilities
viii. Infection Prevention, Documentation, and Quality Improvement
INTRODUCTION
This comprehensive New York Practical Nurse review exam is designed around
advanced practical-nursing knowledge, clinical judgment, patient safety, medication
management, professional responsibilities, and realistic licensing-level decision
making. Questions emphasize application rather than memorization and require the
learner to interpret clinical findings, recognize deterioration, prioritize interventions,
identify scope-of-practice concerns, and select evidence-based nursing actions. The
review also incorporates New York practical-nursing regulatory concepts and the
current NCLEX-PN clinical-judgment emphasis. Learners should expect complex
scenarios involving multiple competing priorities, medication risks, delegation,
ethical dilemmas, documentation, and acute patient changes. The questions are
intentionally challenging and are structured to strengthen readiness for high-level
practical-nursing examinations.
Question 1
A New York LPN is caring for four clients under the direction of an RN. Which client
should the LPN assess first?
A. A client with chronic heart failure who has gained 1.5 kg over 3 days and reports
increased ankle edema
B. A client with pneumonia whose temperature increased from 37.8°C (100°F) to
,38.3°C (100.9°F)
C. A client receiving a blood transfusion who develops dyspnea, chest tightness,
and chills 20 minutes after initiation
D. A client with diabetes whose premeal glucose is 198 mg/dL (11 mmol/L)
Correct Answer: C
Explanation: Dyspnea, chest tightness, and chills during a transfusion may
indicate an acute transfusion reaction. The transfusion should be stopped
immediately and the RN/provider notified according to facility protocol. This is a
time-critical safety priority.
Question 2
An LPN receives an order from a pharmacist to administer a medication to a client.
The pharmacist states that the medication was discussed with the client's physician.
What is the most appropriate action by the LPN?
A. Administer the medication because pharmacists are licensed healthcare
professionals
B. Ask the pharmacist to provide the order in writing before administering it
C. Clarify the order with the authorized prescribing or directing practitioner before
administration
D. Administer the medication if the client's medication administration record
already lists it
Correct Answer: C
Explanation: In New York, LPNs execute medical regimens prescribed or directed
by legally authorized practitioners. A pharmacist's recommendation does not
independently establish an order that the LPN may execute.
Question 3
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min
by nasal cannula. The client becomes increasingly somnolent, with a respiratory rate
of 8/min and shallow respirations. Which action is the priority?
,A. Increase oxygen to 6 L/min
B. Place the client supine and reassess in 15 minutes
C. Assess airway and ventilation immediately and summon appropriate assistance
D. Encourage the client to cough and deep breathe
Correct Answer: C
Explanation: Bradypnea and increasing somnolence indicate potentially life-
threatening hypoventilation. Airway and ventilation take priority. Simply
increasing oxygen may not correct inadequate ventilation and can delay
definitive intervention.
Question 4
An LPN is preparing to administer digoxin to an older adult. The apical pulse is
54/min, and the client reports nausea and seeing yellow-green halos around
objects. What should the LPN do?
A. Administer the medication with food
B. Hold the dose and promptly report the findings
C. Recheck the pulse after ambulation
D. Administer half the prescribed dose
Correct Answer: B
Explanation: Bradycardia, gastrointestinal symptoms, and visual disturbances are
concerning for digoxin toxicity. The medication should be withheld and the
findings promptly communicated to the appropriate practitioner.
Question 5
A client with diabetes mellitus is unconscious, diaphoretic, and has a bedside
glucose of 42 mg/dL (2.3 mmol/L). The client has no IV access. Which intervention is
most appropriate?
A. Give the client oral glucose gel
B. Administer glucagon according to the prescribed emergency protocol
, C. Give the client a carbohydrate-containing beverage
D. Wait for the client to regain consciousness before treating
Correct Answer: B
Explanation: An unconscious client cannot safely swallow oral glucose because of
aspiration risk. Glucagon is an appropriate emergency treatment when severe
hypoglycemia occurs without immediate IV access and is prescribed/authorized
for use.
Question 6
A client with heart failure suddenly develops severe dyspnea, pink frothy sputum,
bilateral crackles, and an oxygen saturation of 82%. Which action should the LPN
take first?
A. Encourage oral fluids
B. Place the client in high-Fowler position and initiate prescribed oxygen
C. Place the client flat with the legs elevated
D. Obtain a routine daily weight
Correct Answer: B
Explanation: The findings are consistent with acute pulmonary edema. Upright
positioning improves lung expansion and decreases venous return, while oxygen
supports oxygenation. Rapid escalation of care is also indicated.
Question 7
A client receiving heparin develops sudden severe headache, vomiting, and
confusion. Which action is most appropriate?
A. Administer the next scheduled dose with food
B. Encourage ambulation to reduce venous stasis
C. Hold further heparin and immediately report the neurological changes
D. Give aspirin to prevent cerebral thrombosis
STUDY GUIDE | TESTBANK | LATEST UPDATE 2026/2027 | 30 ADVANCED
QUESTIONS | 100% CORRECT ANSWERS
Table of Contents
i. New York Practical Nursing Scope of Practice and Professional Regulation
ii. Clinical Judgment, Prioritization, Delegation, and Patient Safety
iii. Pharmacology and Medication Administration
iv. Adult Medical-Surgical Nursing and Complex Disorders
v. Cardiovascular, Respiratory, Neurologic, and Endocrine Emergencies
vi. Maternal-Newborn and Pediatric Nursing
vii. Mental Health, Ethics, Communication, and Legal Responsibilities
viii. Infection Prevention, Documentation, and Quality Improvement
INTRODUCTION
This comprehensive New York Practical Nurse review exam is designed around
advanced practical-nursing knowledge, clinical judgment, patient safety, medication
management, professional responsibilities, and realistic licensing-level decision
making. Questions emphasize application rather than memorization and require the
learner to interpret clinical findings, recognize deterioration, prioritize interventions,
identify scope-of-practice concerns, and select evidence-based nursing actions. The
review also incorporates New York practical-nursing regulatory concepts and the
current NCLEX-PN clinical-judgment emphasis. Learners should expect complex
scenarios involving multiple competing priorities, medication risks, delegation,
ethical dilemmas, documentation, and acute patient changes. The questions are
intentionally challenging and are structured to strengthen readiness for high-level
practical-nursing examinations.
Question 1
A New York LPN is caring for four clients under the direction of an RN. Which client
should the LPN assess first?
A. A client with chronic heart failure who has gained 1.5 kg over 3 days and reports
increased ankle edema
B. A client with pneumonia whose temperature increased from 37.8°C (100°F) to
,38.3°C (100.9°F)
C. A client receiving a blood transfusion who develops dyspnea, chest tightness,
and chills 20 minutes after initiation
D. A client with diabetes whose premeal glucose is 198 mg/dL (11 mmol/L)
Correct Answer: C
Explanation: Dyspnea, chest tightness, and chills during a transfusion may
indicate an acute transfusion reaction. The transfusion should be stopped
immediately and the RN/provider notified according to facility protocol. This is a
time-critical safety priority.
Question 2
An LPN receives an order from a pharmacist to administer a medication to a client.
The pharmacist states that the medication was discussed with the client's physician.
What is the most appropriate action by the LPN?
A. Administer the medication because pharmacists are licensed healthcare
professionals
B. Ask the pharmacist to provide the order in writing before administering it
C. Clarify the order with the authorized prescribing or directing practitioner before
administration
D. Administer the medication if the client's medication administration record
already lists it
Correct Answer: C
Explanation: In New York, LPNs execute medical regimens prescribed or directed
by legally authorized practitioners. A pharmacist's recommendation does not
independently establish an order that the LPN may execute.
Question 3
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min
by nasal cannula. The client becomes increasingly somnolent, with a respiratory rate
of 8/min and shallow respirations. Which action is the priority?
,A. Increase oxygen to 6 L/min
B. Place the client supine and reassess in 15 minutes
C. Assess airway and ventilation immediately and summon appropriate assistance
D. Encourage the client to cough and deep breathe
Correct Answer: C
Explanation: Bradypnea and increasing somnolence indicate potentially life-
threatening hypoventilation. Airway and ventilation take priority. Simply
increasing oxygen may not correct inadequate ventilation and can delay
definitive intervention.
Question 4
An LPN is preparing to administer digoxin to an older adult. The apical pulse is
54/min, and the client reports nausea and seeing yellow-green halos around
objects. What should the LPN do?
A. Administer the medication with food
B. Hold the dose and promptly report the findings
C. Recheck the pulse after ambulation
D. Administer half the prescribed dose
Correct Answer: B
Explanation: Bradycardia, gastrointestinal symptoms, and visual disturbances are
concerning for digoxin toxicity. The medication should be withheld and the
findings promptly communicated to the appropriate practitioner.
Question 5
A client with diabetes mellitus is unconscious, diaphoretic, and has a bedside
glucose of 42 mg/dL (2.3 mmol/L). The client has no IV access. Which intervention is
most appropriate?
A. Give the client oral glucose gel
B. Administer glucagon according to the prescribed emergency protocol
, C. Give the client a carbohydrate-containing beverage
D. Wait for the client to regain consciousness before treating
Correct Answer: B
Explanation: An unconscious client cannot safely swallow oral glucose because of
aspiration risk. Glucagon is an appropriate emergency treatment when severe
hypoglycemia occurs without immediate IV access and is prescribed/authorized
for use.
Question 6
A client with heart failure suddenly develops severe dyspnea, pink frothy sputum,
bilateral crackles, and an oxygen saturation of 82%. Which action should the LPN
take first?
A. Encourage oral fluids
B. Place the client in high-Fowler position and initiate prescribed oxygen
C. Place the client flat with the legs elevated
D. Obtain a routine daily weight
Correct Answer: B
Explanation: The findings are consistent with acute pulmonary edema. Upright
positioning improves lung expansion and decreases venous return, while oxygen
supports oxygenation. Rapid escalation of care is also indicated.
Question 7
A client receiving heparin develops sudden severe headache, vomiting, and
confusion. Which action is most appropriate?
A. Administer the next scheduled dose with food
B. Encourage ambulation to reduce venous stasis
C. Hold further heparin and immediately report the neurological changes
D. Give aspirin to prevent cerebral thrombosis
